眼球按摩对青光眼滤过术后疗效影响的Meta分析

A Meta-analysis on the effect of ocular massage in patients after glaucoma filtering surgery

目的:分析眼球按摩对青光眼滤过术后疗效的影响。方法:计算机检索CNKI,VIP,CBM和万方数据库中关于眼球按摩对青光眼滤过术后疗效(眼压、功能性滤过泡形成、手术成功率)影响的临床随机对照试验(RCTs)。文献发表时间不限。按照纳入与排除标准筛选文献、提取资料、质量评价后,使用RevMan5.3软件进行Meta分析。结果:共纳入20篇文献,共1750例,1757眼,纳入文献中效应量与术后眼压(IOP)相关的文献共10篇,分别对术后2wk,1、3mo眼压情况进行Meta分析。结果显示,各研究间存在较大异质性(I2>50%,P<0.1),采用随机效应模型分析,术后2wk,1、3mo两组患者IOP均有差异[WMD=-0.96,95%CI(-1.83,-0.09),P<0.05;WMD=-2.68,95%CI(-3.81,-1.55),P<0.05;WMD=-3.98,95%CI(-5.00,-2.96),P<0.05]。纳入文献中效应量与手术成功率相关的文献共9篇,随访时间为3-12mo。对其进行Meta分析的结果显示:异质性检验结果为P=0.97,I2=0%,采用固定效应模型进行分析,两组患者手术成功率有差异[RR=1.41,95%CI(1.28,1.55),P<0.05]。纳入文献中效应量与功能性滤过泡形成情况相关的文献共14篇,各研究间存在异质性的可能性很小(P=0.98,I2=0%)。采用固定效应模型进行分析,两组患者功能性滤过泡形成率有差异义[RR=1.33,95%CI(1.23,1.44),P<0.05]。结论:眼球按摩有助于青光眼滤过术后患者更有效地控制眼压并促进功能性滤过泡的形成,从而提高手术成功率。

AIM:To analyze the effect of ocular massage in patients after glaucoma filtering surgery.METHODS:Databases including the CNKI,VIP Information,WanFang and CBM were electronically searched for all randomized controlled trials(RCTs)about comparing the intraocular pressure(IOP),forming efficiency of functional filtering blebs and success rate of filtering surgery between patients with and without ocular massage after receiving filtering surgery.Two reviewers independently screened literature according to the inclusion and exclusion criteria,and evaluated the included studies.Then,Meta-analysis was performed using RevMan5.3 software.RESULTS:Totally 20 eligible studies involving 1757 eyes of 1750 individuals were included to investigate the effect of ocular massage in patients after glaucoma filtering surgery.Ten of the studies were related with IOP.The results of Meta-analysis showed that IOP was better controlled in patients with ocular massage in the postoperative 2wk,1 and 3mo[WMD=-0.96,95%CI(-1.83,-0.09),P<0.05],[WMD=-2.68,95%CI(-3.81,-1.55),P<0.05]and[WMD=-3.98,95%CI(-5.00,-2.96),P<0.05],respectively.Fourteen of the studies were related with the forming efficiency of functional filtering blebs.The results of Meta-analysis showed that patients with ocular massage act better in forming functional blebs[RR=1.33,95%CI(1.23,1.44),P<0.05].Nine of the studies were related with the success rate of surgery.The results of Meta-analysis showed that patients with ocular massage had higher rate of surgery success[(RR=1.41,95%CI(1.28,1.55),P<0.05)].CONCLUSION:Ocular massage can help patients after filtering surgery to control IOP more effectively and promote the formation of functional filtering blebs,so as to improve the success rate of surgery.